Vascular retinal abnormalities in neonates of mothers who smoked during pregnancy.

OBJECTIVE: To investigate whether maternal smoking during pregnancy causes retinal abnormalities in the newborn. STUDY DESIGN: One hundred sixty-two neonates of smoking mothers and 162 matched neonates of nonsmoking mothers (112 appropriate for gestational age [AGA], 30 small for gestational age [SGA], 20 large for gestational age [LGA] in each group) were studied. RESULTS: Retinal arterial narrowing and straightening (RANS) was observed in 52 and 10 eyes of the newborns of smoking and nonsmoking mothers, respectively (P <. 000001) in association with elevated blood pressure in the neonates. The frequency of RANS was more than 3-fold greater in the SGA neonates than in the AGA and LGA neonates of the smoking mothers. Retinal venous dilatation and tortuosity (RVDT) was found in 100 and 36 eyes of neonates of smoking and nonsmoking mothers, respectively (P <.000001). The frequency of RVDT in the SGA neonates of the smoking mothers was 2.5-fold and 4.2-fold greater than in the AGA infants and the LGA infants, respectively. Also, intraretinal hemorrhages were found in 61 and 31 eyes of neonates of smoking and nonsmoking mothers, respectively (P =.0007) in association with elevated hematocrit and RVDT, whereas no intraretinal hemorrhages were found when RANS was present. All retinal abnormalities resolved by 6 months in infants of smoking mothers and by 2 months in infants of nonsmoking mothers. CONCLUSIONS: Maternal smoking during pregnancy causes increased frequency of RANS, RVDT, and intraretinal hemorrhages; but these retinal abnormalities resolve by 6 months of age.

Increased blood pressure in neonates and infants whose mothers smoked during pregnancy.

OBJECTIVE: To determine whether maternal smoking during pregnancy is associated with increased blood pressure (BP) in neonates. STUDY DESIGN: We measured BP in the following groups: (1) 73 neonates of mothers who smoked during pregnancy, (2) 43 neonates of mothers who quit smoking early during pregnancy, (3) 83 neonates of passive smoking mothers, and (4) 170 neonates of nonsmoking parents. Three BP measurements were made at 1, 24, 48, and 72 hours of life. Some of the neonates were followed for 2 years. RESULTS: We observed a significant positive correlation between the number of cigarettes smoked by the mothers during pregnancy and the BP of the neonates. From the first to the seventy-second hour of life the BP in the infants of the mothers who smoked 15 or more cigarettes per day was significantly higher than in the infants of the nonsmoking mothers, whereas the increase in BP was intermediate when the mothers smoked 7 to 15 cigarettes per day. The BP was similar to that of the control subjects when the mothers smoked 3 to 5 cigarettes per day, were passive smokers, or quit smoking during pregnancy. On reexamination between 4 and 9 months and at 12 months, in infants of mothers who smoked 15 or more cigarettes per day both the systolic and the diastolic BP were significantly higher than in the control subjects; at 12 months 5 of the infants of mothers who smoked cigarettes had BP greater than the 95th percentile for age and gender. At 24 months of life there was no significant difference in systolic or diastolic BP between infants of smoking and nonsmoking mothers. CONCLUSIONS: Neonates and infants of mothers who smoked during pregnancy have an elevation of BP that is related to the number of cigarettes smoked per day. Smoking 15 or more cigarettes per day may cause BP elevation in infancy, but the BP returns to normal during the second year of life.

Increased levels and positive correlation between erythropoietin and hemoglobin concentrations in newborn children of mothers who are smokers.

The mean erythropoietin concentration in the cord blood of neonates whose mothers were smokers was greater than in neonates whose mothers were not smokers. There was a significant positive correlation between erythropoietin and hemoglobin concentrations. The findings suggest that approximately one of five fetuses who are exposed to tobacco smoke are in a state of chronic hypoxia.

Fucosidosis: detection of the carrier state in peripheral blood leukocytes.

We have utilized the fluorogenic substrate 4-methylumbelliferyl-alpha-L-fucoside to measure the activity of alpha-L-fucosidase in white blood cells and serum. We have compared the findings with those using the P-nitrophenyl derivative. pH activity curves showed two major peaks of activity in leukocyte lysates, with different specificities to these substrates. alpha-L-Fucosidase activity was determined in peripheral leukocytes. Isolated mononuclear cells (mainly lymphocytes), and granulocytes in 21 members of a family in which fucosidosis had occurred and in normal control subjects. The activity in the leukocytes, lymphocytes, and granulocytes of the normal subjects was 300.7 +/- 79.8, 190.1 +/- 43.9, and 281.9 +/- 73.1 nmoles 4-methylumbelliferone/mg protein/hour with the fluorogenic substrate, and 150.0 +/- 31.8, 154.8 +/- 21.0, and 148.3 +/- 48.3 nmoles p-nitrophenol/mg protein/hour with the colorigenic substrate, respectively. No activity was detected in the patients' cells with the colorigenic substrate, whereas with the fluorogenic substrate the apparent activity varied from 0.5 to 1.1. In the lymphocytes of both of the patients' parents, two grandparents, and six other potential carriers, the activity fell between the normal and patients' values. Great variation in alpha-L-fucosidase activity, with broad overlap between normal subjects and heterozygotes, was observed in serum and plasma. Our findings indicate that detection of carriers for fucosidosis is possible by direct fucosidase determinations in isolated mononuclear cells.